Tejera Ramírez C, Siles Quesada C, Reyes Suárez D, González Azpeitia G, Gresa M, Martínez Sopena J, Quero Jiménez J
Servicio de Neonatología, Hospital Materno-Infantil, Las Palmas.
An Esp Pediatr. 1997 Feb;46(2):177-82.
The objective of this study was to evaluate the efficiency and response of gas exchange by the use of high frequency respiratory modalities in cases rescued after failure of conventional mechanical ventilation.
A retrospective study of twelve premature infants that required high frequency ventilation (HFV) as rescue therapy for treatment of respiratory distress syndrome (RDS) because of failure of conventional mechanical ventilation (CNV) were studied. The mean weight and gestational age were 1,041 gr (500-1,730) and 28 weeks (26-34), respectively. Fifty percent of the infants weighed less than 1,000 grams. Two different respiratory apparatus were used. Five infants were treated using Infant Star and seven with Babylog 8000. The variables were analyzed by comparison of the means with significance taken as p < 0.05.
High frequency ventilation was initiated at 24 hours of life (2-86) and the mean duration was 33 hours (1-133). We saw a significant improvement in oxygenation after starting HFV and during the first and second controls after HFV initiation. PaO2 increased from 59 mmHg to 87 (HFV-initial), 119 mmHg (HFV-first control) and 98 mmHg (HFV second control; p < 0.05). Likewise, a/AO2 increased from 0.087 to 0.13 (HFV-initial), 0.19 (HFV-first control) and and 0.18 (HFV-second control; p < 0.05). The oxygenation index (OI) decreased from 23 to 16 (HFV-initial p < 0.05) and to 11 during the first and second controls (p < 0.01). Despite the improvement in oxygenation, there were no differences in mean airway pressure levels. We did not see any change in PaCO2 levels. The mortality rate was 58%, with a mean age at death of 82 hours of life (6-264).
High frequency ventilation might be used as a rescue therapy for treatment of respiratory distress syndrome since there is an improvement in oxygenation.
本研究的目的是评估在传统机械通气失败后进行抢救的病例中，使用高频呼吸模式时气体交换的效率和反应。
对12例因传统机械通气（CNV）失败而需要高频通气（HFV）作为呼吸窘迫综合征（RDS）抢救治疗的早产儿进行回顾性研究。平均体重和胎龄分别为1041克（500 - 1730克）和28周（26 - 34周）。50%的婴儿体重低于1000克。使用了两种不同的呼吸设备。5例婴儿使用婴儿之星进行治疗，7例使用Babylog 8000进行治疗。通过比较均值分析变量，显著性水平设定为p < 0.05。
高频通气在出生后24小时（2 - 86小时）开始，平均持续时间为33小时（1 - 133小时）。开始高频通气后以及高频通气开始后的第一次和第二次检查期间，氧合有显著改善。动脉血氧分压（PaO2）从59 mmHg升至87 mmHg（高频通气初始）、119 mmHg（高频通气第一次检查）和98 mmHg（高频通气第二次检查；p < 0.05）。同样，肺泡动脉氧分压比值（a/AO2）从0.087升至0.13（高频通气初始）、0.19（高频通气第一次检查）和0.18（高频通气第二次检查；p < 0.05）。氧合指数（OI）从23降至16（高频通气初始，p < 0.05），在第一次和第二次检查时降至11（p < 0.01）。尽管氧合有所改善，但平均气道压水平没有差异。动脉血二氧化碳分压（PaCO2）水平未见变化。死亡率为58%，平均死亡年龄为出生后82小时（6 - 264小时）。
由于氧合有所改善，高频通气可作为呼吸窘迫综合征的抢救治疗方法。
